BNF for Children (BNFC)

8th July 2025

BNF for Children

This update contains 10 significant changes, 2 dose changes and 4 new monographs.

Significant Changes:

• Antibacterials, principles of therapy: updated guidance on notifiable diseases.
• Asthma, acute: update to criteria for severity of acute asthma attacks.
• Immunisation schedule: updated guidance for immunisation against respiratory syncytial virus.
• Ivacaftor with tezacaftor and elexacaftor (Kaftrio®): risk of psychological side effects [MHRA/CHM advice].
• Ocular corticosteroids: cautions updated (advice in betamethasone, dexamethasone, fluorometholone, prednisolone; see example in fluorometholone).
• Ocular NSAIDs: cautions updated (advice in diclofenac sodium, ketorolac trometamol; see example in diclofenac sodium).
• Respiratory syncytial virus immunisation: updated guidance.
• Salbutamol: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Terbutaline sulfate: reminder of the risks from overuse in asthma and to be aware of changes in the SABA prescribing guidelines [MHRA/CHM advice].
• Thiopurines and intrahepatic cholestasis of pregnancy [MHRA/CHM advice] (advice in azathioprine, mercaptopurine, tioguanine; see example in azathioprine).

Dose Changes:

• Palivizumab [update to indications and dose].
• Pimecrolimus [update to dosing for short-term treatment of mild to moderate atopic eczema (including flares) when topical corticosteroids cannot be used].

New Monographs:

• Abrysvo® [respiratory syncytial virus (RSV) vaccine].
• Andembry® [garadacimab].
• Artesunate.
• Noxafil® [posaconazole].

10th June 2025

BNF for Children

This update contains 7 significant changes, 3 dose changes and 2 new monographs.

Significant Changes:

• Hydroxychloroquine sulfate: updated pregnancy and breast-feeding advice.
• Malaria, prophylaxis: updated guidance.
• Neonatal infection, antibacterial therapy: updated guidance Sepsis: updated guidance on management.
• Parenteral anticoagulants: updated guidance for use of heparin flushes.
• Sepsis: updated guidance on management.
• Sympathomimetics: updated guidance for septic shock.
• Tuberculosis: updated guidance for multi-drug resistant tuberculosis.

Dose Changes:

• Rilpivirine [update to dosing for HIV-1 infection].
• Sodium hyaluronate with trehalose [update to dosing for dry eye conditions].
• Vocabria® (cabotegravir) [update to dosing for HIV-1 infection].

New Monographs:

• Apretude® [cabotegravir].
• Duvyzat® [givinostat].

13th May 2025

BNF for Children

This update contains 5 significant changes, 1 dose change, 2 new monographs, 3 new preparations, and 1 deleted preparation.

Significant Changes:

• Amphotericin B: review of indications and dose for liposomal preparations, as well as updates to directions for administration, breast-feeding, pregnancy, cautions, and monitoring advice.
• Asthma, chronic: updated guidance on management.
• Budesonide with formoterol (DuoResp Spiromax® 160 micrograms/4.5 micrograms): new indication and dose for mild asthma, reliever therapy.
• Budesonide with formoterol (Fobumix® 160/4.5 Easyhaler): new indication and dose for mild asthma, reliever therapy.
• Prolonged-release opioids: removal of indication for relief of post-operative pain [MHRA/CHM advice] (advice in all opioids; see example in oxycodone hydrochloride).

Dose Changes:

• Rosuvastatin [update to dose adjustments due to interactions].

New Monographs:

• Ospolot® [sultiame].
• Winlevi® [clascoterone].

New Preparations: Fobumix® 80/4.5 Easyhaler [budesonide with formoterol]; Fobumix® 160/4.5 Easyhaler [budesonide with formoterol]; Fobumix® 320/9 Easyhaler [budesonide with formoterol].

Deleted Preparations: Ambisome® [amphotericin B].

8th April 2025

BNF for Children

This update contains 7 significant changes, 2 dose changes, 2 new monographs, and 1 deleted monograph.

Significant Changes:

• Anaemia, iron deficiency: updated guidance for oral iron.
• Emtricitabine with tenofovir alafenamide: new indication and dose for pre-exposure prophylaxis of HIV-1.
• GLP-1 and dual GIP/GLP-1 receptor agonists: potential risk of pulmonary aspiration during general anaesthesia or deep sedation [MHRA/CHM advice] (advice in dulaglutide, liraglutide, semaglutide; see example in liraglutide).
• Immunisation schedule: updated guidance for immunisation against diphtheria, tetanus, pertussis and poliomyelitis in children aged 3 years and 4 months.
• Oral iron: indications and doses updated for iron-deficiency anaemia (advice in ferrous sulfate, ferrous fumarate, ferrous gluconate, sodium feredetate; see example in ferrous sulfate).
• Sodium valproate: new advice for male patients already taking sodium valproate [MHRA/CHM advice].
• Valproic acid: new advice for male patients already taking valproic acid [MHRA/CHM advice].

Dose Changes:

• Dupilumab [update to dosing].
• Evinacumab [update to dosing].

New Monographs:

• Agamree® [vamorolone].
• Joenja® [leniolisib].

Deleted Monographs: Ferrous sulfate with folic acid.

11th March 2025

BNF for Children

This update contains 1 significant change and 2 new preparations.

Significant Changes:

• Pneumococcal polysaccharide conjugate vaccine (adsorbed): name change of Apexxnar® to Prevenar 20®.

New Preparations: Hyftor® [sirolimus]; Verorab® [rabies vaccine].

11th February 2025

BNF for Children

This update contains 1 dose change, 2 new monographs, 1 new preparation and 1 deleted monographs.

Dose Changes:

• Ferric carboxymaltose [update to age range for iron-deficiency anaemia].

New Monographs:

• Loargys® [pegzilarginase].
• Xalkori® [crizotinib].

New Preparations: Prostap PD DCS® [leuprorelin acetate].

Deleted Monographs: Co-simalcite.